Scott Beilfuss and David Austin met this week with Bryan Johnson, new CEO of St. Mary’s hospital, to talk about making healthcare more affordable in the Grand Valley as well as other issues facing the hospital. Mr. Johnson, who was COO of St. Mary’s before becoming CEO this summer when Dr. Brian Davidson left to return to the Denver area has extensive healthcare administration experience in the Utah medical community before coming to Grand Junction in 2016. The meeting came from an invitation to the Chamber of Commerce community from Mr. Johnson (MC Dems are members) to clarify information recently presented at the local Healthcare Summit put on by the Chamber. At the meeting, Kim Bimestefer, Executive Director of the Colorado Department of Healthcare Policy and Finance took some shots at St. Mary’s charges and finances implying they were a high cost hospital compared to “similar” hospitals on the front range.
As some of you know, Scott Beilfuss is a local healthcare advocate and David Austin is a retired hospital CFO who was very helpful in navigating some of the challenges St. Mary’s faces. We talked about a variety of topics with Mr. Johnson who was very open and frank with us about where St. Mary’s is and where they are going.
Some of the highlights we covered at the meeting are:
-Mr. Johnson recognizes that the pressure is on to bring their costs down and is implementing a TCC (Total Cost of Care) management plan to bring more efficiency to healthcare delivery at St. Mary’s. Partially due to the plan, St. Mary’s has been able to keep costs flat over the last several years and last year they achieved savings of $10 Million dollars through efficiency improvements.
-St. Mary’s is designated as the Sole Rural Provider in our area due to their ability to offer a broad array of services and being a Level 2 trauma center. This gives them a higher reimbursement rate on Medicare, but also requires them to keep up a broad range of services and readiness to provide for this area which is not close to other major healthcare centers.
-A major reason that St. Mary’s appears to have higher costs compared to the “similar” hospitals on the front range was a huge difference in the patient acuity ratio. This simply means that St. Mary’s on the average serves patients who are need much more help. Because many hospitals in the Denver area are close to specialty hospitals, they often stabilize patients and send them on, a process in the industry called “drip and ship”. Here, they must keep of a very broad range of specialties and readiness to serve those patients who would be further harmed by long transports and who want to recover close to family.
-The proposed “Centers of Excellence” program being designed at the Colorado Department of Healthcare Policy and Finance is proposing moving patients with certain specialty procedure needs to hospitals with lower costs and better outcome ratios. There is a danger that this would require patients here to be transferred to hospitals on the Front Range due to their better outcome rates. In effect this could greatly diminish or eliminate some specialties here.
-The insurance pay mix at St. Mary’s leans very heavily on serving Medicare and Medicaid patients with only 19% of their patients on private pay insurance. Because government insurance reimbursements are low, private pay does get hit with higher rates. On the possibility of the Public Option plans being worked on, Mr. Johnson said he felt a regulated single pay system would be more efficient.
-Mr. Johnson acknowledged that addressing the shortage of primary care physicians would help bring down healthcare costs through early detection and prevention. To help with that St. Mary’s will start a new primary care practice next year with the goal of adding 6 more primary care physicians and provide financial and other support to existing primary care groups. The Grand Valley is short about 20 primary care physicians.
-Mr. Johnson felt that it is critical for the long-term financial viability of healthcare on the Western Slope that more collaboration take place. We currently have a 20% excess of hospital beds here as well as growing duplication of services which adds to higher costs. Hospitals can not work together to address these problems due to the Federal Trade Commission rules against price fixing. With an FTC exemption local healthcare providers could work together to create collaborative agreements that would prevent excessive services that drive up costs.
-St. Mary’s does help support Marillac Clinic through support services and some financial funding.
David and Scott both felt that St. Mary’s and Bryan Johnson are taking a strong leadership position to keep a high level of healthcare available on the Western Slope.
We look forward to further discussion about the possible Public Option plans, single pay insurance, legislation to help with healthcare costs and future needs here. If there is interest, the Mesa County Democrats would like to host healthcare discussions with local leaders in the future. We continue to advocate for affordable healthcare availability for everyone to be covered with access everywhere.